Just out of sheer curiosity, if one is pulled from residency due to inability to pass Step III prior to the end of internship and transferred to the MSC, are they also demoted in rank back to 2LT/O1?

It's about that time of year again when my anxiety runs wild. Hopefully it'll be like every other time and I will come out fine in the end. It's just a bit scary how hardcore the MEDCOM people are being about the Step III requirement for interns.

Senior Member

Just out of sheer curiosity, if one is pulled from residency due to inability to pass Step III prior to the end of internship and transferred to the MSC, are they also demoted in rank back to 2LT/O1?

It's about that time of year again when my anxiety runs wild. Hopefully it'll be like every other time and I will come out fine in the end. It's just a bit scary how hardcore the MEDCOM people are being about the Step III requirement for interns.

It is pretty hard to fail Step III. In the day, when tests used something other than a PC, the expression went:
Part I, you study for 2 months
Part II, you study for 2 weeks
Part III, you show up with 2 #2 pencils.

The Lorax

Just out of sheer curiosity, if one is pulled from residency due to inability to pass Step III prior to the end of internship and transferred to the MSC, are they also demoted in rank back to 2LT/O1?

It's about that time of year again when my anxiety runs wild. Hopefully it'll be like every other time and I will come out fine in the end. It's just a bit scary how hardcore the MEDCOM people are being about the Step III requirement for interns.

I've only heard of one individual who went from MC to MSC. This particular individual failed internship and was given the option to repeat or go MSC. The latter option was chosen. Never heard anything since.

I doubt you can lose rank because it is set by congress and the president(?).

Heard of one intern who failed Step III. That intern became a GMO and had to have direct supervision until the boards were passed.

I have heard of this too, that usually you're put into GMO status until you pass. Apparently, the new big wig at MEDCOME is nuking people for not complying. We had two residents in another department get pulled and made MSC officers because they did not pass by the deadline.

Well one still needs to pass USMLE III or the COMLEX equivalent to be even a GMO. The requirements for GMO is passing internship year and USMLE to practice without direct supervision, hence why one would be made MSC.

Officers cannot be demoted(Flag Officers serve in positions that are designated for certain # of stars and can therefore go up/down); however........

In order to go from MC to MSC you would have to be re-commissioned into the MSC. You would effectively resign your MC commission and then could technically be commissioned into the MSC at whatever rank they wanted.

This is the same thing that happens to prior officers who then join the MC.

Screw the GST

Back when I interviewed for USUHS (1992), that day interviewing with me was an ensign from the MSC, but had naval aviator wings. I asked about this: he said he'd lost 3 planes, so he was bounced off the flight line, and recommissioned from an O-3 line officer to O-1 MSC, with leave to apply for medical school.

Junior Member

Well one still needs to pass USMLE III or the COMLEX equivalent to be even a GMO. The requirements for GMO is passing internship year and USMLE to practice without direct supervision, hence why one would be made MSC.

Senior Member

Officers cannot be demoted(Flag Officers serve in positions that are designated for certain # of stars and can therefore go up/down); however........

In order to go from MC to MSC you would have to be re-commissioned into the MSC. You would effectively resign your MC commission and then could technically be commissioned into the MSC at whatever rank they wanted.

1) Officers can be demoted, but it often takes a General Courts Martial. There have been many instances in which this has happened. One notable was a 2 star who was brought back on active duty, found guilty of misconduct and reduced in rank back to O6. I would also argue that all of the prior commissioned officers who head off to USUHS or join HPSP are in essence demoted although not due to bad behavior.

2) There is no need to resign a commission or be re-commissioned in order to shift corps. This is an administrative process handled via the community managers and PERS. Again, does not happen often, but does happen.

Senior Member

Just out of sheer curiosity, if one is pulled from residency due to inability to pass Step III prior to the end of internship and transferred to the MSC, are they also demoted in rank back to 2LT/O1?

It's about that time of year again when my anxiety runs wild. Hopefully it'll be like every other time and I will come out fine in the end. It's just a bit scary how hardcore the MEDCOM people are being about the Step III requirement for interns.

Dude, have you talked about your significant fear of failure with your therapist???? I have lost count of the number of threads you have initiated because you were worried about failure at the next level. You really need to learn to relax. Step 3 is the easiest of the boards and you should have no problem passing. Remember less than 10% fail. Are you dumber than 90% of the interns in the US? I doubt it.

The Lorax

I heard of a sailor who was given a billet that came with an early promotion from LT to LCDR. It was an engineering position on a sub. Somehow the promotion was tied to the billet. This individual was was moved and they tried to take his promotion away. Not sure what happened.

60% of the time it works everytime

1) Officers can be demoted, but it often takes a General Courts Martial. There have been many instances in which this has happened. One notable was a 2 star who was brought back on active duty, found guilty of misconduct and reduced in rank back to O6. I would also argue that all of the prior commissioned officers who head off to USUHS or join HPSP are in essence demoted although not due to bad behavior.

2) There is no need to resign a commission or be re-commissioned in order to shift corps. This is an administrative process handled via the community managers and PERS. Again, does not happen often, but does happen.

1)I believe you are correct on this; however, 99.9% of the time you see it, you see it in regards to someone being "demoted" back to their last paygrade at which they served "honorably" in which is the instance of which you speak. I believe there was also an instance of someone going back to O-3 or O-4 recently after it was found they had some long running scam going on. I have never heard of an officer on active duty being demoted and remaining on active duty.

Ether Man

We had an intern who was dumb as a rock, horrible judgement, lazy, poor at receiving criticism, etc. All around worthless dude. Maybe the worst intern ever. He repeated 2 or 3 months of internship, was deemed untrainable and bounced to the MSC as a LT. He was dangerous and had no clinical judgement at all. It's unbelievable he could have graduated from medical school.
One CRNA I had the displeasure to work with was a naughty fellow, and an all around jackhole. He was busted down from CDR to LCDR and tossed out. No pension for you. It still makes me smile. He was rude and stupid. I'm sure he's a militant CRNA now in the civilian world.
I would like to run into him at the ASA or something (not that the CRNAs belong). I have a smirk waiting.

Regards,
Il Destriero.“The truth is incontrovertible, malice may attack it, ignorance may deride it, but in the end; there it is.”.

Personally know an MSC officer who was an intern 1 year ago; passed Step III, didn't pass internship...on to MSC land. Did not get demoted. No word if he's going to be in a leadership position or not, can't see an O-3 platoon leader, and can't see a company command without PL time. I see an admin career for the next 7 years of payback. (As a former MSC guy, I'd rather be shot in the face...twice.)

And I would also strongly agree that going to USUHS and becoming an O-1 again IS a demotion (Although not TECHNICALLY; resigned commission, separated, recommissioned in same branch as an O-1. Imagine the pay issues that came about with that nut-roll). Save pay made it easier to swallow, but being treated like a 2LT all over again, and being paid the same respect as someone who had been in the Army for less than a minute was less than tolerable. Usually the respect factor was quickly regained when I worked with someone for more than a minute and they realized (or I thought they realized) I was a little more experienced than the average butter bar. Still didn't take away the sting when a 1LT nurse pulled rank because I was an easy target; just bit my tongue and moved along...most of the time.

Shi*ter's Rule

I wouldn't worry about it, I knew an intern who failed it twice and then was forced to take a prep course and passed it on his 3rd try. So atleast you will get 3 tries before they send you to MSC land.

"Government's view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it." - Ronald Reagan

Thyroid Storm

We had an intern who was dumb as a rock, horrible judgement, lazy, poor at receiving criticism, etc. All around worthless dude. Maybe the worst intern ever. He repeated 2 or 3 months of internship, was deemed untrainable and bounced to the MSC as a LT. He was dangerous and had no clinical judgement at all. It's unbelievable he could have graduated from medical school.

I also knew an intern who got fired from his residency. He was transferred to MSC and busted down to LT. I don't know the specifics of how the demotion process works, but officers do somehow get demoted.

@HooahDOc: I seriously doubt they'd demote and transfer you just b/c you failed step 3 once. The military has invested LOTS OF MONEY into you by the time you finish internship. They won't just transfer you into MSC willy nilly.

I also knew an intern who got fired from his residency. He was transferred to MSC and busted down to LT. I don't know the specifics of how the demotion process works, but officers do somehow get demoted.

@HooahDOc: I seriously doubt they'd demote and transfer you just b/c you failed step 3 once. The military has invested LOTS OF MONEY into you by the time you finish internship. They won't just transfer you into MSC willy nilly.

It's not exactly willy nilly, but it sort of is. Basically we are required to have a passing score on Step III by June 01 of our intern year. If we do not have a passing score at this time, we are done. No admin leave for prep courses, no admin leave for additional study time, nada -- you're done. You are terminated from residency and placed into MSC as a O1 to serve your ADSO.

I'm curious why June 01 was chosen, but I think I know the reason -- so you can't actually complete a year of internship ship and be able to gain a permanent license even if you are axed from residency. Also, many states have a maximum time limit on when you can complete the series of board exams. Most state that you MUST complete ALL STEPS within 7 years of your initial Step I. This means anyone who gets stuck into the MSC to pay back their ADSO will be at or beyond the 7 year mark, essentially prohibiting them from ever becoming a physician.

My first encounter with military brilliance has basically forced me to decide NOT to do 20 years and get out ASAP. Even though I will more than likely pass Step 3 and be fine, I'm pretty sure I'm done once my ADSO is up. I'm completely amazed at how one person with a little power can institute such an asinine policy.

The rules never used to be quite this harsh, and pretty much the majority of faculty and upper level residents are quite shocked about what is going on.

You've got to take everything you hear in the military with a grain of salt. A lot of times those in charge get a power trip out of making exaggerated threats, etc. I remember another doctor told me about a situation where a Navy Captain in Kuwait assembled a bunch of doctors and told them all he was volunteering them to roll up into Iraq. The truth was all along he knew that was never going to happen.

Gotta wonder if some of that logic applies to the situation you applied. Wait until someone doesn't pass. Chances are what actually happens might be different than the threats.

Screw the GST

Most state that you MUST complete ALL STEPS within 7 years of your initial Step I. This means anyone who gets stuck into the MSC to pay back their ADSO will be at or beyond the 7 year mark, essentially prohibiting them from ever becoming a physician.

Even in the service, you can take 2 days off. If you were MSC, you could still study for Step III (if needed) and take the exam within that 7 years. After getting out, though, it would take some explanation to get into a program to complete a residency (as the one year of internship would be like a GMO, except the following 3 years as MSC instead of GMO would not be actively practicing). Still, it would not be unheard of, as long as one was all right with redoing internship (possibly/likely).

You've got to take everything you hear in the military with a grain of salt. A lot of times those in charge get a power trip out of making exaggerated threats, etc. I remember another doctor told me about a situation where a Navy Captain in Kuwait assembled a bunch of doctors and told them all he was volunteering them to roll up into Iraq. The truth was all along he knew that was never going to happen.

Gotta wonder if some of that logic applies to the situation you applied. Wait until someone doesn't pass. Chances are what actually happens might be different than the threats.

This was kind of everyone's attitude when news of the new policy came down -- until the Dude In Charge brought the hammer down on people who didn't comply. They are now serving out their time in the MSC.

Attending

It's not exactly willy nilly, but it sort of is. Basically we are required to have a passing score on Step III by June 01 of our intern year. If we do not have a passing score at this time, we are done. No admin leave for prep courses, no admin leave for additional study time, nada -- you're done. You are terminated from residency and placed into MSC as a O1 to serve your ADSO.

I'm curious why June 01 was chosen, but I think I know the reason -- so you can't actually complete a year of internship ship and be able to gain a permanent license even if you are axed from residency. Also, many states have a maximum time limit on when you can complete the series of board exams. Most state that you MUST complete ALL STEPS within 7 years of your initial Step I. This means anyone who gets stuck into the MSC to pay back their ADSO will be at or beyond the 7 year mark, essentially prohibiting them from ever becoming a physician.

My first encounter with military brilliance has basically forced me to decide NOT to do 20 years and get out ASAP. Even though I will more than likely pass Step 3 and be fine, I'm pretty sure I'm done once my ADSO is up. I'm completely amazed at how one person with a little power can institute such an asinine policy.

The rules never used to be quite this harsh, and pretty much the majority of faculty and upper level residents are quite shocked about what is going on.

Why do you think the military and taxpayers should pay you as a physician if you can't function as a physician? This is likely an outgrowth of the deluge of untrainable physicians who are entering HPSP via the marginal medical schools and the reality that the quality of the HPSP applicant pool has declined significantly. I think anything which seeks to maintain quality is an ok policy. If you are affected, it is your doing not the military's.

1) Officers can be demoted, but it often takes a General Courts Martial. There have been many instances in which this has happened. One notable was a 2 star who was brought back on active duty, found guilty of misconduct and reduced in rank back to O6. I would also argue that all of the prior commissioned officers who head off to USUHS or join HPSP are in essence demoted although not due to bad behavior.

2) There is no need to resign a commission or be re-commissioned in order to shift corps. This is an administrative process handled via the community managers and PERS. Again, does not happen often, but does happen.

In the Army National Guard, you can lose rank with you switch branches. I will lose my 0-3 when I recommission as a Medical Student from the Specialty Branch as a Physician Assistant. I will be an 02 with a few years of credit. Their is a NGB policy regarding constructive credit for prior service. In the guard you get 6 months credit for every year as a commissioned officer. I am sure active duty is different.